General Symptoms of Pregnancy

Fatigue

An overwhelming feeling of fatigue is often one of the earliest signs of pregnancy. Such feelings usually subside during the second trimester, but are likely to return in the third trimester.

Causes

The main causes of extreme fatigue in early pregnancy are massive hormonal changes and the extra demands on the body made by an increase in blood volume of up to 50 percent. It's this increase in blood volume that helps the lining of the uterus to thicken and the placenta to develop. In the second trimester, energy levels usually return to normal as hormone changes settle down. Late in pregnancy, fatigue may recur because your extra size and weight and the demands of the growing baby means that your body systems need to work harder. In both early and late pregnancy, difficulty sleeping (see You are 6 Weeks and 5 Days) can contribute to feelings of fatigue. Fatigue in pregnancy can also be caused by anemia.

What to do

If you are working, take regular breaks and get some fresh air at least once a day. Ensure that your fluid intake is adequate; caffeine is not helpful because it dehydrates your body and will leave you feeling worse. Take more time for sleep if you need to; housework can wait and you may need to cut back on social commitments.

Difficulty sleeping

It's very common to have sleeping difficulty in pregnancy, especially in the first and third trimesters.

Causes

A common cause of disturbed sleep is the need to urinate frequently. Early in pregnancy, this is due to the amount of blood in your body, leading to the kidneys filtering out more fluid, which ends up in your bladder. As pregnancy progresses, another factor is expansion of the uterus within the pelvic cavity, so that it competes for space with the bladder. This leads the bladder to require more frequent emptying, which will interrupt your sleep. Many women also feel hungry during the night and need to snack, while others find that nausea and vomiting interrupt their night or lead to early waking. From about 20 weeks of pregnancy, the uterus moves up out of the pelvis, taking pressure off the bladder, and nausea often subsides, which means that sleep improves. Toward the end of pregnancy, sleep patterns can once again be disturbed. Unborn babies are often active just when you want to rest; your body is bulky and finding comfortable sleeping positions becomes difficult; and as the baby becomes bigger and heavier pressure on the bladder may return.

What to do

If frequent urination is keeping you awake, don't drink large quantities of fluid close to bedtime, and to avoid waking up hungry include foods high in unrefined carbohydrates, such as whole-wheat bread, in your evening meal. If you do wake up, don't lie there for long periods, since this is frustrating and may lead to habitual sleeplessness. Get out of bed and engage in a simple activity that won't overstimulate your brain, have a warm, caffeine-free drink, and return to bed when you're sleepy. Later in pregnancy when you find it difficult to get comfortable, experiment with different sleeping positions: use plenty of pillows, under your head and belly and between your knees. A rest during the day is essential during late pregnancy, but limit this to a 20-minute power nap or an hour reading or watching television with your feet up. If you sleep for long periods during the day, you will further lessen your ability to sleep at night.

Headaches

Headaches are common in pregnancy, especially in the first trimester.

Causes

Most headaches are unlikely to be a cause for concern and are probably due to hormonal changes and the need for additional fluids. Headaches occurring in the third trimester that are accompanied by other symptoms, such as abdominal pain or nausea, may be a sign of preeclampsia and should be assessed by a doctor .

What to do

Making sure you drink enough clear fluids (around five cups a day) and avoiding caffeine should help reduce the number and severity of headaches. If you're working or concentrating on a task, have a break every two to three hours, and get some gentle exercise in fresh air. For a sinus headache, apply a warm compress to the front and sides of your face. For tension headaches, place a cool compress on the back of your neck. If you suspect your headache is due to lack of sleep, get more sleep. And make sure you're eating enough, since hunger and low blood sugar can cause headaches. Relieve stress-another headache trigger-with deep breathing, meditation, yoga, or massage Always discuss your symptoms with your doctor before taking medication.

If you have a headache in late pregnancy that is accompanied by swelling of the legs and ankles, generalized body swelling, abdominal pain, or nausea and vomiting, contact your doctor immediately.

Swollen feet and ankles

Some women experience a small amount of swelling in their feet, ankles, hands, and wrists, which can be particularly pronounced in hot weather.

Causes

Swelling is the result of fluid retention, which in turn results from the extra blood produced during pregnancy to provide for the growing baby.

What to do

This is best managed by alternating light activity with periods of rest during which your feet are elevated. However, staying in bed or sitting in a chair for very long periods may increase the risk of deep vein thrombosis (DVT) . DVT is a potentially serious condition in which a blood clot forms in a vein; if the clot breaks off, it may travel to the lungs and block a major blood vessel. Swollen feet and ankles can also be a sign of other problems such as preeclampsia, so should always be reported to your doctor who can check for other symptoms.